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PROVINCE OF NOVA SCOTIA

DELAYED REGISTRATION OF BIRTH

65200370

TO THE REGISTRAR GENERAL OF NOVA SCOTIA

I hereby make application for the Registration of Birth of Mary RitaWilliams Sex Female

Date of Birth April 8, 1924 Place of Birth SydneyCounty of Cape Breton

Name of Father Richard Williams MAIDEN NAME of Mother Marie Deveaux

Residence of Father when child was born Sydney, Cape Breton Co., NS Present address of Father Brooklyn, New York, USA

Occupation of Father at Birth of child Steel Workeer Place of birth of Father Bay Bulls, Newfoundland

Race Name and present address of Physician in attendance at birth

Signature of Applicant Mrs. Richard Williams Address of Applicant Sydney, Cape Breton Co., NS Date 5 July 1926

Relationship of Applicant to child Mother

AFFIDAVIT

IN THE MATTER of the application for the Registration of the Birth of Mary RitaWilliams

Born at Sydney in the County of Cape Breton

That Mary RitaWilliams Whose Birth is sought to be registered was

born at Sydney Cape Breton County on April 8, 1924

My knowledge of the fact and date of such Birth is based on the following Circumstances:

From the enclosed certificate of birth and baptism taken from Church records, and I am her mother and know the date and place of birth of my daughter, Mary Rita Williams

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